President Trump, advisor @SWAtlasHoover arguing there's lot of false coding of COVID

This is junk news

Like junk food, junk news tastes good but has no nutritional value

So what are the facts?

Don't hospitals get more $ for COVID?

Thread on hospital billing, COVID, and fraud
Our payment system is insanely complex

So this is a simplification

Hospitals get paid based on what condition patient has

A patient with pneumonia?

Typical hospital might get between $8K to $11K from Medicare, depending on whether pt has major comorbid conditions or not

So what happened in COVID era?

Cares Act gives hospitals a 20% bump (to about $9600 – 13K) if pneumonia is from COVID

Additional $1600 - $2200 for a typical COVID pneumonia patient

To get this bump, hospitals must document that patient is COVID positive

Don't incentives change billing practices?

Why yes!

Hospitals famous for documenting comorbidities to get higher reimbursement

What folks DON’T do is make up false diagnoses

That'll get them fined, jailed

Most Docs, hospitals would NOT lie about a positive COVID test

But may be extra $2K might lead hospitals to test their pneumonia patients for COVID?

Actually, even without incentives, any hospitalized patient with pneumonia today will get tested for SARS-CoV2

And if positive, they have COVID

Which gets us to another trope....

Another trope is that someone died "with" COVID, not "because of" COVID.

This is clinical nonsense

If you have pneumonia and are COVID positive?

You have COVID pneumonia. You are sick from COVID

Ah, what about the stories of car accident victims who tested + for COVID?

More nonsense

There is no higher reimbursement that I can find for car accident victims who are COVID+.

And if you bill these patients as COVID pneumonia, that's fraud

This is Facebook junk

Why did Congress, President enact a law that gives hospitals extra $ for COVID?

Higher payment for COVID because policymakers knew hospitals would need extra money getting PPEs.

The federal govt wasn't going to get PPEs

This was a way to help make hospitals whole

And it hasn’t.

Most hospitals are bleeding money from COVID

What about stories of $40K for a COVID death?

That's MS-DRG 207: pneumonia patient who spends >4 days in ICU on ventilator

Without COVID, Medicare pays about $35K. With COVID, about 40K

Again, doctors aren't taking random deaths, calling them COVID deaths

That's fraud

So does COVID diagnosis get hospitals a little extra $?


Are physicians, hospitals lying about who has COVID?


Are people dying “with” COVID, not “because of” COVID?

Clinical nonsense

So lets ignore the noise and misinformation about COVID billing, etc.

While doctors and nurses are dying on the front lines,

our leaders aren't working to get them protective equipment

Instead, they are falsely accusing our front line providers of fraud

Its reprehensible
You can follow @ashishkjha.
Tip: mention @twtextapp on a Twitter thread with the keyword “unroll” to get a link to it.

Latest Threads Unrolled: